Case Study: The Deadly Choices At Memorial

Nearing the end of my shift in the Emergency Department, I was requested to accompany a patient while the nurse readied the discharge papers. Upon entering the bay, I met a very small and fragile patient who was anxious to go home. Conflicted between my primary duties and responsibilities to complete training for two inexperienced volunteers, I decided to put forth my interests in teaching by demonstrating compassionate care to my trainees. Although the patient repeatedly refused my assistance, I gave my best effort to calm her as I cloaked a warm blanket around her. As I listened to her confide in me of all of her hospital anxieties, I was shocked from the lack of quality care she had received which made her feel more sick after the first

The floodwaters of Hurricane Katrina marooned Memorial Medical Center in Uptown New Orleans [1]. Disaster struck leaving patients helpless, and doctors and nurses with confusion and stress. The article “Deadly Choices at Memorial” by Sheri Fink describes, in just the right amount of detail, the crisis that MMC faced because of Hurricane Katrina in 2005. Although the article was able to state a few good things that were done by medics at the hospital, it mostly showed all of the flaws that exist in the medical system. This causing us to face reality and face our problems head on.

In the wake of a natural disaster, people are forced to realize they may not make it out alive; this was the thought of over one hundred and eighty patients who were at Memorial Medical Center in New Orleans, Louisiana after Hurricane Katrina hit. Sheri Fink’s Deadly Choices at Memorial tells the story of what doctors and nurses had to do when the hospital, which was being used as a shelter, lost all power and had to evacuate all one hundred and eighty patients in August of 2005. Usually most people have time to think about their choices so they are certain they are making the correct one, but in a time of crisis the doctors and nurses on staff at Memorial had to make harsh decisions about who of the one hundred and eighty patients they would evacuate, who would go first, who would go last and who would have to stay behind. Fink’s article makes

It is important to remember that care of the patient does not end when the patient dies. After the death there is still work to be done in the form of comforting the bereaved family members. It has been reported that some

Medical, trauma, and emergency knowledge was needed in assessing victims of the attacks, in deciding who needed or did not need medical care and in which order was most beneficial to the time and for the greatest use of supplies available. The days, weeks, months, and years required to recover from these incidents not just in the hot zone, but medically and mentally have set forth implementation of how we focus our efforts before, during, and after hazards strike. The affects of September eleventh, have taught us as first responders and government officials valuable information on disaster response and recovery efforts.

One ethical consideration is the staff that was called and did not attempt to make it into work according to our nurse manager’s statements. These employees will be counseled and reminded of the disaster relief policy. Another is in refusing to take responsibility for the death of the patient. If there was the proper amount of staff members on shift , the food allergy could have been discovered before improperly administering the wrong medication to the patient. Regardless of being short staffed it is the responsibility of the staff member to provide safety and that all medical questions are answered.  A third is that lack of responsibility for the falls. Staff members are required and ensure the safety of all patients and rounds should have been in full force. I also believe that patients should have been moved a open area so that it is easier to be able to see all patients. Although the patients may be awake and oriented, they may be suffering from effects of illness or medication that increase the likelihood of falls and this should have been addressed with the assessment that staff is required to do on all patients.

Occasionally, the best care a nurse can provide is providing their patient the ability to have a good death. In a survey of acute care nurses conducted by Becker, Wright, & Schmitt (2016) it was found that dying well was

Hospitals see death, arguably, more than anywhere else. Scrubs explores this reality and how employees mentally deal with dying. In the world of doctors and nurses, taking care of the sick and dying is an every day task. It can be an emotionally overwhelming job, but it teaches the inevitability of death as a part of life. In this show, J.D. experiences death within his first days of his job as a resident. His patient refuses to get dialysis, stating that she is nearing the end of her life, and trying to save her life at this point is futile. That same day, the patients of Turk and Elliot, J.D.’s friends, die as well. Unlike J.D., they had tried to save their patients who ended up dying anyway. This teaches them all an important lesson that day: death surrounds them inside and outside the hospital. Unlike people who do not work in hospitals, the three doctors would have to get used to seeing

Flash forward to the 21st century. Medical care and evacuation after natural or man-made disasters haven't been as effective as they could be because of the lack of medical personnel, equipment and hospital-grade supplies

Many nurses are regularly confronted with the hopelessness and exhaustion of patients and their families making it difficult for them to find balance between the preservation of life and the enablement of a dignified death. Nurses must acknowledge their own feelings of sorrow, fear, dismay and helplessness and recognize the impact of these emotions in clinical decision making. These distressing pressures may cause a nurse to contemplate intentionally assist in ending a patient's life as a humane and compassionate answer, however; the conventional goals and standards of the nursing profession mitigate against it.

Jennings-Sanders, Frisch & Wing (2005) demonstrate that nurses, other healthcare professionals, emergency services, and both non-governmental and governmental organizations must work in collaboration during these situations in order for the best outcome to prevail. It is essential in a disaster situation that nurses involved in the care of patients must be able to shift their

Right after safety huddle, I attended a meeting that included Mrs. Greenwood, the director of Human Resources, and the director of the Emergency Department. This meeting was scheduled to discuss termination for cause of another employee that had been diverting narcotics from the Omnicell. Mrs. Greenwood explained that the hospital had standards and this employee was not upholding those standards; thus, termination was a necessity. I agree that termination is the appropriate course of action for this nurses’

Written by Derek Humphry, “Final Exit” is a book written to guide doctors, nurses, and families of patients on how to handle a patient’s request or doctor’s recommendation for euthanasia. Although “Final Exit” was written in 1991, the information it contains, still applies to today. The year it was published, it went on the New York Times bestseller list for 18 weeks and in April 2007, the editors and book critics of American national newspaper USA Today selected “Final Exit” as one of the 25 most memorable books of the last quarter

By spending time in IPU, I hoped to gain a better understanding of the process of death – from recognising the final hours of life, death, and communicating with the family. A patient was identified to me by the consultant on ward rounds as approaching death. I was asked to observe the signs from the patient, so these could be discussed with the doctor in depth. Some of the signs identified were a cachexic appearance, terminal agitation, Cheyne stokes respiration and reduced alertness. Over the next few hours the patient was monitored closely until they died that afternoon. Before the patient died, I was also able to sit in on the consultation

“Active euthanasia defines the practice where death is caused by direct administration of a lethal substance” (Sayers, 2005). Dr. Jack Kevorkian is a physician well known for his cases of physician assisted suicide. “In his writings and statements, Kevorkian advocates a society that allows euthanasia for the dying, the disabled, the mentally ill, infants with birth defects and comatose adults; and he sanctions experiments prior to their death and organ harvesting.” (Betzold, 1997). Many other physicians and also nurses have performed euthanasia causing public alarm that some cases are actually murder. In one such case a physician and his nurse, Dr. James Gallant decided to take a Ms. Clarietta Day life into his own hands: “Day collapsed on the phone while calling 911 in the early morning of March 22. She was taken to the hospital and diagnosed with a subarachnoid hemorrhage (burst blood vessel in the brain), a condition that is invariably fatal. Sometime before she died, Day had filled out an advance directive, which included instructions from August 1995, in which she wrote that should she become unconscious, she wished to be kept alive for at least forty-eight hours. However, following the diagnosis, Day received painkillers every five to ten minutes for a four-hour period, even though there was no documentation that Day was in discomfort or agitated. She was removed from a respirator and had a magnet applied to her